Individual
MARIE LYNN MATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
704 E FLINT ST, DAVISON, MI 48423-1245
(810) 228-6574
Mailing address
10422 DODGE RD, OTISVILLE, MI 48463-9766
(810) 228-6574
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
MI
Other
Enumeration date
08/23/2023
Last updated
08/23/2023
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